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Evaluation of mycology laboratory proficiency testing
A A Reilly1, I F Salkin, M R McGinnis
1Wadsworth Center, New York State Department of Health, Albany, New York 12201-0509, USA. Andrew.Reilly@Wadsworth.Org
Journal of Clinical Microbiology
|June 12, 1999
Summary
Overt proficiency testing (OPT) may overestimate laboratory accuracy in medical mycology. Covert proficiency testing (CPT) revealed higher fungal identification error rates for common pathogens, indicating OPT limitations.
Area of Science:
- Medical Mycology
- Clinical Laboratory Science
- Diagnostic Accuracy
Background:
- Overt proficiency testing (OPT) regulations aim to improve laboratory performance.
- The unblinded nature of OPT may lead to laboratories optimizing performance for tests rather than reflecting routine patient testing accuracy.
Purpose of the Study:
- To evaluate medical mycology overt proficiency testing (OPT).
- To compare fungal specimen identification error rates between OPT and covert (blinded) proficiency testing (CPT).
Main Methods:
- Compared identifications from 188 laboratories in NY State mycology OPT (1982-1994).
- Compared these with fungal identifications from patient specimens in 1989 and 1994 from 88 of these laboratories (CPT).
Main Results:
- OPT error rates could be predicted from specimen consistency.
- Error rates for Candida albicans were similar in OPT and CPT.
- Significantly higher error rates were observed in CPT for Candida tropicalis, Candida glabrata, and other pathogenic fungi.
Conclusions:
- OPT may not accurately reflect typical laboratory performance in medical mycology.
- Differences in error rates may be due to OPT using ideal specimens and conditions.
- OPT has limitations in assessing the quality of routine medical mycology laboratory performance.